Functionality of Pituitary Tumors Impacts Sinonasal Quality of Life Before and After Endoscopic Surgery.

Abstract

Local effects of pituitary hormones in the sinonasal region are not well characterized. We sought to examine sinonasal quality of life outcomes in functional and non-functional pituitary tumors after endoscopic skull base surgery. Retrospective Medical Record Review. Three hundred four patients who received endoscopic resection of a pituitary tumor at a tertiary skull base center reviewed. This population was divided into non-functional and functional groups. Surgical outcomes and pre and postoperative quality of life scores were examined. Preoperative total SNOT 22 scores were not different overall between the two groups, but the rhinologic and extra-nasal rhinologic subdomain scores in the functional group were higher than in the non-functional group (3.57 ± 3.95 vs. 2.58 ± 3.64, and 1.48 ± 2.2 vs. 0.92 ± 1.75 respectively) (p = 0.04 and 0.02). Change from baseline in overall postoperative SNOT 22 score was significantly greater in the functional group at 6 weeks post-operation (6.75 ± 17.51 vs. 1.4 ± 16.83 respectively) (p = 0.03). Time to normalization on nasal endoscopy was longer in the functional group compared to the non-functional group (p = 0.02). Corticotrophic and somatotrophic tumors affect quality of life both pre- and post-operation. Patients with functional tumors took longer to reach full healing and normalization of the sinus cavity. These findings can be used to counsel patients about different expectations during the immediate postoperative healing period, but also to reassure them that regardless of tumor functionality, they will be able to reach a good quality of life after endoscopic skull base surgery.